Topic 1b: Psychodynamic Approach {by 9/16}

There are two readings due this week – Text Ch. 8 and Freud’s lectures (3-5). Address the following two discussion points: (1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods? (2) What are your thoughts about “transference” in therapy? Be sure to support both of your responses by the readings (i.e., not anecdotal opinions). Your original post should be posted by the beginning of class 9/16. Have your two replies no later than 9/18. *Please remember to click the “reply” button when posting a reply. This makes it easier for the reader to follow the blog postings.

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(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?

Test like the Rorschach and Thematic Apperception prove to be very controversial manors of testing for many reasons. The nature of the tests allow patients to have a lot of freedom in their answer so assessing the answers as a clinician leaves a lot of room for interpretation which also leaves a lot of room for human error. When looking at the example of a TAT psychological assessment in the text(Mischel, W., & Shoda, Y., 2008) the book took time to note that much of the the focus of the report was hypothesized underlying themes that may be interplaying the client. There was also very little specific statements made from the analysis mainly generalizations. The other problem with this testing is that Freud’s intention was to access repressed and suppressed memories. In doing so he found that patients would create false memories which sometimes they integrated as truth. In doing so this made some suggestible patients more apt to more symptomatic response. Freud also made reference to the criticisms more widely towards psycho-analytic treatment which protective methods are under the umbrella of, comparing it to a surgeon who is doing surgery. Stating surely there will be adverse reactions to an operation which will cause temporarily worse symptoms. Freud’s argument is if the long term effects cure the initial cause then why wouldn’t they use the treatment.(Freud, S., 1977) The problem with this statement come that there was little research universalizing this method in the text to support that claim that the long term results were going to heal the patient. This left many patients without resolution.

(2) What are your thoughts about “transference” in therapy?

Transference is an inevitable in psycho-analytic theories. (Mischel, W., & Shoda, Y., 2008). When applying transference to modern day therapeutic models it seems that this phenomenon still is evoked but it is no longer necessary as it was in psychoanalytic theory. When looking at Freud’s model of approaching transference in psychoanalytic theories, his frameworks were that of working through the transference. This idea is still in practice today in many therapeutic models. Intellectualizing feelings and the reason that they are brought upon us by individuals. A lot of therapeutic models find that identifying feelings and their functions serve as an integral part of breaking habitual patterns of feelings. In summary my thoughts on transference are that although not necessary to therapy it is something that can occur and needs to be addressed within the clinician and patient interactions as means to moving towards healthier coping strategies that may prove to be no longer helpful towards the everyday health of the client.

In regards to your response to the second question, it seems as we both drew to the same conclusion that although transference can be a useful tool and actually a necessary part of psychoanalysis, for modern day therapy, it is not essential. Transference in modern day therapy can be seen when the client unconsciously and unrealistically expects the therapist to behave like important people from client’s past and projects other relationships onto therapist. Also, I agree with your closing thought on how that when transference does occur, it needs to be addressed within the patient and therapist interaction in order for the patient to move on to learn healthier coping strategies.

In response to #2 Question- I agree, the relationship and interaction between the client and the therapist should be a means towards healthier coping strategies. In my opinion, as therapists our emphasis should be based on empowerment, practical problem solving, development of positive coping skills, and reinforcement of strengths and supports. As an effective therapist, one should evaluate their own belief systems, or countertransference. Be compassionate and sensitive. Don’t be afraid to show your humorous as well as your serious side. Hear what the person is saying, but also what he is not saying. Use your mind, heart, eyes, and ears to listen. Recognize that people and families have long standing patterns of communication and means of coping with stress. Attempting to interrupt or change their usual patterns will just increase the stress. Respond to concerns with compassionate honesty. If you don’t know the answer, just say so. Never force communication. You must develop the ability and sensitivity to know when a client and non-communicative person are ready to talk. Talk about the ‘here and now’ at first. As a therapist, one can be most helpful if they have no agenda as to how the patient resolves his complex issues of identity, affiliation, and openness, and do not push for premature resolution in these areas. In being honest with myself, it comes naturally for me to “fall into” a maternal therapist role in a caring, protective and nonjudgmental atmosphere.

Bridget,
I really appreciate your perspective on transference. I, at times, disregard the idea of transference too quickly. I think you’re exactly right when you say you don’t think transference is necessary yet there is a strong possibility of it happening. When it does I think it’s very important for the therapist to acknowledge it is happening and help the client learn different effective coping mechanisms. I think it’s really important also for the therapist to remind the client that although some people and relationships will remind them of past relationships and people it’s critical to remember that the people and the relationships are different.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?

Mischel, Shoda, and Ayduck (2008) state that projective methods are personality tests that are structured in an open-ended format with the purpose of the test being unknown to the person taking the test which allows them to answer in any way he or she pleases. The way a projective method works is that the evaluator will show an equivocal stimuli followed by questions, which will provoke an open-ended answer (2008). This method is favored by practitioners with psychodynamic backgrounds they believe the unconscious is exposed through the response from the open-ended structure.

Even though this method is favored by practitioners with psychodynamic backgrounds, there is little to no scientific support for the use of projective methods. In a review completed by Kihlstrom (2003), there was no evidence presented that projective methods reflected a person’s unconscious (Mischel, Shoda, Ayduck, 2008). With that being said, there are many dangers to the practice of psychology with the continued use of these methods. Being that there are is no scientific support for these methods, there is major concern over whether the insight the psychoanalyst draws from these methods are accurate or useful (2008). There is a heavy emphasis on the clinician’s intuition and own judgement based on how they “feel” about it or their experience within the field. With the field of psychology having a heavy emphasis on research, the continuous use of projective methods which lack both reliability and validity is dangerous to the practice of psychology.

(2) What are your thoughts about “transference” in therapy? Be sure to support both of your responses by the readings (i.e., not anecdotal opinions).

Transference in therapy is when the patient sees and reacts to the therapist as if they were the patient’s father, mother, or an important person from their childhood (Mischel, Shoda, Ayduk, 2008). Within these relationships, both feelings and problems, are transferred to the relationship with the therapist. With transference, it allows the therapist to show the patient their childhood conflicts while also helping them work through them with the goal of ultimately facing the conflicts (2008). Transference is a great tool for psychoanalysts because of the insight achieved by the patient and they are able to work through their problems in different contexts until the patient learns how to deal with them. For psychoanalysis, transference seems to be a useful and necessary tool but for other forms of therapy, transference is not necessary. Transference allows patients to go back to their problematic childhood relationships through the therapist whereas with a therapy approach such as CBT that would not be necessary or useful because it is rooted in the “here and now” approach targeting a set of specific problematic behaviors (2008).

I agree with what you are saying about the lack of scientific support in regards to projective methods. I feel that for a clinician to use these tests in the modern world of therapy, it should solely be for them to gain more insight into the client and not actually “diagnose” or “label” them with something because of their results. If a clinician feels that they may be able to get the individual to open up more by one of these tests or that they may learn something new then I think using it is fine. However, when they are being used to actually show support or to differ in something that someone has said then I think they should not be accepted as hardcore evidence, which goes along exactly with what you have said.
In regards to transference, I agree that it can be a very useful tool in therapy. However, when a therapist doesn’t catch the transference quick enough or if they feed into it too much, this can create a very negative environment for the client. They can become too attached or actually get angry and benevolent towards the clinician. I feel that as long as their a balance between the two then transference can be managed in a healthy and proactive way in the relationship between the client and the therapist.

Brittany, I think you made several great points and hit on some points that my own post missed. The ambiguous nature of the Rorschach Test relies on the client being unaware of the intentions of the test. While I did not comment about this on my own post, I question the ethics regarding the administration of any psychological measurement that relies on deceit to obtain information. The interesting part, that you touch on in great depth, is that these projective tests tend to be more tests of the clinician’s projections onto the client’s response. This obviously brings us to the notion of whether there is any validity or reliability of these measures, which there’s not. To use a measure that lacks these features raises quite the debate on the ethics of its application but it appears that the Rorschach still holds its roots and may for some time. Also, I agreed with your assessment of transference. In psychodynamic therapies it is a very useful tool or vehicle by which to assess the unconscious projections of the client. While some transference may still occur in therapy sessions rooted in different theories it is most certainly not emphasized to the same extent as in Freudian Psychodynamics. Research shows that features such as quality of the therapeutic relationship are much more important and transference could possibly challenge the therapeutic relationship.

Brittany,
You make a very valid point that transference can be used as a way to cope with past experience. Although I would argue it’s not necessary and its important that the clinician understands and is mindful that it is happen because if not approached delicately it can cause more harm the good. It’s important that the clinician identify and self monitor there reaction because even the slightest negative response can really damage the trust and openness of the therapeutic relationship.
-brie

(1) Psychological tests without scientific support can lead to negative consequences for clients. The Rorschach and Thematic Apperception Test are still used by therapists today, but are so open-ended that they leave much of the assessment up to the therapist’s interpretation and intuition (Mischel, Shoda & Ayduk, 2008). This means that the same person could be given one of these tests by several different clinicians and receive completely different feedback from each one of them. The disparity in assessment outcomes would be even greater if the clinicians came from different theoretical backgrounds. Furthermore, these projective tests have not shown reliability and validity, and have not shown scientifically in any way that they reflect a person’s unconscious motivations as they intend to (Michel et al., 2008). Without more accurate assessments, how can we be confident that we are giving the client the best possible care? How can a clinician, with good conscience, make a treatment plan for a client based solely on their own opinion of responses to such tests?

Other methods used in psychodynamic therapy can lead to poor outcomes as well. For example, searching for repressed memories may lead to false memories. Although some recovered memories may be legitimate, some are not (Mischel et al., 2008). This can have huge negative consequences for the client, who now has to deal with trauma that may or may not be real, but it can also impact the lives of those they have accused. This is not to say that victims are making up stories, but that where there is high suggestibility and vast consequences, clinicians should be cautious when using techniques designed to dig up unconscious memories.

(2) Frued spoke of transference as a key component of successful psychoanalytic therapy (Freud, 1977). However, his description leaves me with more questions than answers. The idea that every interaction between client and therapist is analyzed, and that the therapist attempts to remain ambiguous and distant in order to foster the client’s transference, seems to complicate the therapeutic relationship. This is also an example of a way the therapist is assessing the client using their own subjective interpretation, based on Freud’s theoretical perspective, to make serious judgments about the client. I also question, is the client made aware that in the process of therapy, everything that they say or do is being interpreted in some way? Are they aware that the therapist believes they are treating them like someone significant in their life? Also, how does the therapist determine who it is they think the transference is about? When and how is this addressed and used as a tool throughout the psychoanalytic/psychodynamic process?

I appreciate that you brought up the fact that transference actually creates more questions for you than it does provide answers. I completely agree. But I also feel as though many of Freud’s other constructs and theories also raised more questions than they did answer. I think this speaks to his broad contributions to the field of psychology in terms of making professionals look at and understand mental illness in a different way, and also to the idea that he did not contribute much more than that. I know that this is a bold statement, and that many would not necessarily agree, but most of his theories have been proven inaccurate, lacking empirical evidence, or unethical in many cases. To credit someone with being the father of psychology, I feel as though his theories should answer more questions than they raise.

I completely agree with your reasons for why projective methods should not be used! We gave similar examples as to why they are not reliable. I also feel that because different therapists practice using different theories it makes the results of these tests very skewed and subjective. I also like how you spent time talking about repressed memories and how when the therapist can lead the patient to create false memories it can result in them being even more upset than they were when they came into the therapy relationship. In regards to transference, I feel like I had a lot of the same questions that you do. I think that Freud put a lot of pressure on the relationship between the client and the therapist and I also agree that it doesn’t seem to be spelled out if the patient even knows what is going on during the therapy session in regards to transference and these other methods of psychodynamic practice. I think that there are definitely some good things that came out of psychodynamic theory but there are also many questions that seem to go unanswered.

Colleen, you bring up one of the biggest concerns of the applications of the Rorschach Test. The fact that these measures show no inter-rater reliability speaks to the reality that these projective measures have no place in modern therapy. When controlling for inter-rater reliability any measure should show some variation, but the fact that these specific projective measures can produce different interpretations from cooperating therapists is concerning. Even test-retest reliability can be called into question as unique responses can be given for each assessment and unique interpretations created by the analyst. One of my biggest concerns, the you touch on, is the power analysts have in creating false memories. With multiple studies supporting the propensity for the implantation of false memories of sexual or physical abuse it is concerning that analysts would engage in methods that elicit these false memories. Your analysis of transference was spot on and addressed many of the holes in the theory. As I commented on Brittany’s post, I feel as though transference would compromise the therapeutic relationship and the information gathered from transference would not be as significant as any changes fostered by a healthy therapeutic relationship. With the ambiguous nature of psychoanalytic theory I truly do wonder how aware a client of a psychoanalytic therapist would be of the processes of therapy.

Colleen,
You make a great point when you say that the projective methods leave room for a lot of ambiguous interpretations. I agree that by using these methods, therapy may become very subjective relying solely on the judgment, bias or prejudice of a clinician. You bring up a good point when you say that these methods can lead to a disparity of assessment outcomes when multiple clinicians with varying backgrounds use them to assess a client. According to Michel et al. (2008), there is no scientific evidence that projective methods actually lead to the unconscious or that the unconscious actually exists. The questions for me that arise from using a psychodynamic approach are whether or not the “signs” of personality (which are interpreted by a clinician, relying on a clinician’s judgment) then valid? Or are they just subjective opinions? One key problem with the psychodynamic approach using these projective measures is that they are subjective and rely solely on clinician discretion, which may be biased. This introduces a whole set of issues in the interpretation, diagnosing and treatment aspects of therapy in general.

Colleen,
You make some valid points. I think the thing to remember is that transference is a concept that seems to explain an even that some people have with there clinicians but it is something that there is no hard and cold way of dealing with clients and clinicians all have therapeutic relationships as complicated as any other relationship in ones life and negotiating around the rough patches is all part of the relationship building process. I think it is important if you were not sure about how to approach it with a particular client you would seek supervision to get another perspective. There is so much grey in our field and we are always working to get solid answers but with so many variables there is always many ways to approach one challenge.
-Brie

Although a number of practitioners with psychodynamic backgrounds use methods like the Thematic Apperception Test (TAT) — a projective method that involves interpreting a client’s needs and conflicts through a series of photos— and the well-known Rorschach test— a series of inkblots which allow for clients to tell their own unique stories—there are a number of dangers for using such methods.

When prompted with a TAT test, a client is shown a number of pictural scenes, like “a mother and daughter, a man and a woman in the bedroom, a father and son,” (Mischel, Shoda, Ayduck, 2008, p.181). Clients are then prompted to provide unique stories for each situation, including a plot, the character’s feelings and experiences, as well as the story’s resolution. With this method, practitioners believe that they can use the information to unveil clients’ hidden conflicts and even fantasies. According to Mischel et al. (2008), “It is expected that people will interpret the ambiguous pictures presented according to their individual readiness to perceive in a certain way,” (p.181). However, the issue with this method, along with the Rorschach test, is that it has no scientific foundation; practitioners are expected interpret such stories without a clearcut method on how to do so. What makes this concept of using projective methods even trickier is the fact that each practitioner has his or her own background in the field of psychology, which range in theoretical focus, so every TAT and inkblot test is interpreted differently from each practitioner. For example, one person who tells a story about a mother and a daughter arguing over everyday problems will likely be interpreted differently by a number of practitioners, revealing a variety of information about the client. Mischel et al. (2008) even confirms this when mentioning that “the clinician interprets the themes intuitively in accord with his or her particular theoretical orientation,” (p. 181). Adding to this, each practitioner has his or her own perceptions about the world based off of their own unique past experiences, which may provide a bias or even a filter when interpreting clients’ stories. Overall, leaving a diagnostic test open to interpretation seems merely silly.

Some practitioners may not use projective methods, but the concept of transference is present in every session according to psychoanalysts (Mischel et al., 2008). Transference, which “occurs when the patient responds to the therapist as if he or she were the patient’s father, mother, or some other important childhood figure,” (Mischel et al., 2008, p.193), is an interesting and important aspect to therapy. Allowing the patient to explore feelings with a therapist in this light will ultimately lead to more in-depth, fearless discussion of a patient’s problems. In other words, if a therapist is seen as a childhood figure, such as a parent, then the patient will not feel judged or condemned when exploring his or her feelings. This openness and judgement-free zone will allow for both a patient and a therapist to work through the patient’s issues, ultimately leading to a successful therapy session. According to Freud (1977), this concept of transference is “one of the most important observations which confirms [his] hypothesis of the sexual instinctual forces operating in neuroses,” (p.51). Although I must still be convinced that that transference is linked to sexuality — a term Freud uses more broadly than how it is normally defined— I do agree with his idea that transference can “spontaneously” occurs in all human relationships. It is not something that is forced, but something that happens naturally, especially with the patient and the practitioner in a therapy setting. In the words of Freud (1977), “psycho-analysis does not create [transference], but merely reveals it to consciousness…” (p. 51). I believe transference is one of the key aspects to a successful therapy session; perhaps a level of trustability and empathy from the practitioner will allow for transference to develop sooner for the patient.

I particularly liked what you said about the therapist’s involvement in interpreting the tests. I think everyone can agree that it is nearly impossible to be completely unbiased 100% of the time, particularly when dealing with highly emotional issues. While a therapist may not feel as though they are imposing their own beliefs or judgments on a client, their interpretation can prove otherwise and may be more of a reflection of themselves rather than a proper interpretation of the client’s unconscious emotions. To think that professionals would be comfortable with the potential of imposing their own biases and experiences on a client is more dangerous than the fact that many often do. To continue to allow for such tests to be conducted with little to no empirical evidence and so much room for error speaks volumes to the reasons psychodynamic therapy is rarely practiced in the modern era.

Though many practitioners still use projective methods to evaluate clients, the lack of evidence supporting these tests creates an uncertain future for psychological practice. Projective methods use open-ended questions and ambiguous stimuli to evoke “projected” inner thoughts and feelings. Although projective tests have been shown to have some validity, there is little evidence to suggest the results of the tests reflect the unconscious mind (Mischel, Shoda, & Ayduk, 179). Much of the controversy over tests, such as the Rorschach and Thematic Apperception Test, is the excessive room for interpretation of test findings. Often times a patient’s responses are scored against others of a similar age and other loose factors that the therapist determines (Mischel, Shoda, & Ayduk, 180). With no rigid structure, there is too much room for interpretations to be biased and affected by the specific knowledge base or experiences of the therapist, rather than by empirical evidence. Another potential issue with these types of tests is the possibility of eliciting responses that the patient does not necessarily feel strongly about. With the expectation of having to give a response to a so-called authoritative figure, patients may feel pressured to say certain things that may not be accurate. They may also give a response that could be misinterpreted and lead them to create a false memory or to recollect a situation differently than the way it actually occurred. This could be especially true for those people who are in distressed emotional states and are looking for any answer that might explain their troubles. While the results of such tests can be beneficial for some people, the likelihood of misinterpretations or further harming the client emotionally or mentally far outweigh their possible benefits.
Transference is the result of a safe environment created by the therapist to allow the patient to respond to them as if they were an important childhood figure (Mischel, Shoda, & Ayduk, 193). In psychotherapy this could be a useful tool in order to work out issues that may have been left unresolved in childhood. Although the term is primarily used in psychodynamic therapy, I think transference is a common occurrence in all therapy. When talking about difficult issues in a safe environment with a mostly ambiguous therapist, it wouldn’t be abnormal for a person to lash out or develop an attachment to the therapist. While often times in modern therapies the therapist acknowledges that the patient has transferred their feelings about someone or something else onto them and proceeds without “working out” the issue by playing into it, it is not entirely unproductive for the patient to gain insight and see that their emotions have overtaken their ability to rationally process them. While I think that this could be useful if it happens by chance and is used in a productive way to gauge the client’s emotional state, I do not think it should be something that is either encouraged or forced in order to role play the unresolved childhood issues.

I agree with your attitude toward transference. You made a good point when you said that while it may happen by chance, it is not something that should be encouraged or forced. A therapist should not assume that transference is going to occur, because doing so creates certain assumptions about the treatment needs of a client, which should be based primarily on what the client consciously communicates to the therapist. Over time, a therapist may make inferences about the deeper meaning behind a client’s behaviors, but for many clients transference simply will not be a factor.

Jillian,
I found your opinion on the use of transference really interesting! While I don’t think transference is essential to therapy I think it can be used wonderfully as a tool to give a client insight, especially if they have poor insight. A client who isn’t aware of how they communicate with family and friends may start to demonstrate how they communicate if they experience transference and start to see their therapist as a friend or family member. This experience could assist the therapist in making the client more aware of how their behavior towards friends and family might feel for their friends and family.

1. Freud believed that projective methods were a great way to begin the therapy relationship with a client. In using these, you can gain a better understanding of what is going on within the patient’s mind. According to Mischel, Shoda, and Ayduk (2008) in projective methods the purpose of the test isn’t disclosed to the patient and they are allowed to speak freely and interpret what they are seeing however they deem fit (p. 179). Two examples of projective tests are the Rorschach test and the Thematic Apperception Test (TAT). The Rorschach test was designed to help the therapist gain a better understanding of aspects of their personality, creativity, their grasp of reality, and their anxiety (Mischel et al., 2008, p. 180). The TAT was designed to help the therapist understand the underlying needs of the patient. It also helps them to predict any potential problems or conflicts that they may experience (Mischel et al., 2008, p.181). Both of these tests are scored very subjectively and rely on the therapist to have a lot of insight into the test that is being given. The Rorschach has more of a strict guideline when it comes to scoring the answers that the patient’s give. There have been many manuals that have been published to help the therapist correctly interpret the answers that are provided to them. However, the TAT is scored much more subjectively and mainly relies on the therapist’s individual ideas and practices (Mischel et al., 2008, p. 180-181). I believe that this is a main issue when using these projective methods. The fact that you are relying solely on the interpretation from the therapist can in some ways be very problematic. It also creates many issues in the reliability of the test itself. If I take the Rorschach test with one therapist and then a year later take it with another one and get completely different results, how is this really helping me or the therapist better understand my personality? However, I do believe that there may be some instances when the use of these tests could benefit the therapist and patient relationship. If a patient is very slow to open up to the therapist and has clearly suffered some traumatic experiences, using the TAT during the initial assessment can open the patient up more and also give the therapist more insight into what is going on in their mind. With that being said, I believe that these tests should not be used in interpreting the patient’s personality. There are many other reliable and valid techniques that are out there in modern therapy that can offer the therapist insight into the patient’s personality.

2. According to Mischel, Shoda, and Ayduk (2008) transference in therapy occurs when “the patient responds to the therapist as if he or she were the patient’s father, mother, or some other important childhood figure” (p.193). What this means is that the patient projects feelings that they have toward someone in their life onto the therapist. Usually this occurs because the therapeutic relationship is one where the patient feels safe and that they can be honest and open about certain feelings. Freud (1977) states that this transference sometimes comes off as affection but is usually hostility. He also explains that when the patient transfers these emotions that were once repressed in their unconscious onto the therapist, they can begin to deal with the feelings in the physical environment that they have with the therapist (Freud, 1977). Completing these readings only furthered my belief that transference happens of a daily basis in our lives. We don’t always “take out” our frustrations on the person that is causing that frustration. For example, if you have a terrible day at work because your boss yelled at you, the chances of you yelling back at them are very low. This is because you most likely do not want to lose your job. So instead you go home and you yell at your children or your significant other because that is a safe environment that you know is stable. This is the same thing that happens in the patient-therapist relationship. When you begin to feel safe with your therapist and you know they are there for you emotionally, you begin to transfer your feelings towards another figure in your life onto them. I think that as long as the therapist is using this transference in a productive way, and allowing it to help with the progress of the patient, then it is helpful and expected. However, when the therapist doesn’t react quickly or correctly to the transference there can be many maladaptive behaviors and thoughts that the patient begins to have and this can be problematic to the therapist and to the treatment plan.

I liked your input regarding the practice of using projective measures in therapy. While I’m sure most people at this point would agree that these tests should not be used to measure personality, it had not occurred to me that they might be useful for simply helping the client open up to his or her therapist. The only issue I could see with that–particularly regarding the Rorschach test–is that these tests already have a reputation as personality tests. Most patients would assume that therapists were using it to gain insight into their unconscious thoughts, and that might make patients feel a little uneasy. However, if the therapist made his or her intentions clear and presented it more as a game, then I could see projective tests creating a good start for a therapist-client relationship.

Marisa,
Transference in therapy can be used positively to help a client “work through” conflicts that arise or are revealed in the transferred relationship. To have transference occur, a client must feel that they are in a safe space to be open and let out their feelings. I think you said it best when you mentioned how transference can occur in our daily lives not just in a therapeutic environment. You elaborated on why we would be more likely to transfer our hostility to people we care about rather than just the source of those feelings; we need to have a safe environment where you feel supported emotionally in order to start working through some of the feelings that arise in our interpersonal relationships. You made a great point when you said that it is important that when this occurs in a therapeutic relationship, it is important to act on transference, when it occurs naturally, correctly because it is true that transferring feelings and conflicts onto other people can lead to maladaptive situations. It is important that we, as future therapists, learn to adaptively use transference to help clients.

I like the way you wrote about projective methods being useful in other ways. Although there have been attempts to make the Rorschach and TAT more reliable and valid, they still rely on a great deal of subjectivity. However, for some therapists they may be used as a way to start the conversation. I feel like this might especially be true for the TAT, as some cards may prompt certain conversations in a less threatening way. It does seem as though the Rorschach may still come off as intimidating though, as we have seen in plenty of movies and jokes on TV, it is well-known and has a reputation. A client may feel more threatened, that the therapist is analyzing everything they say, and that they may respond incorrectly and be labeled as “crazy.” With that being said, some other clients might find it a fun exercise if presented correctly. I think this leads to the understanding that we need to be aware of our clients and what they may or may not be comfortable with, based on culture and demographics.

1.) Projective methods are used as tests by clinicians to elicit test takers to provide reflections of their unconscious inner life based on their answers. These methods, which include Rorschach tests, thematic apperception tests, word associations, and sentence completion tests, could prove to be dangerous if the psychology field continues to use them in practice because the results are very unreliable and rely more on a clinician’s intuition rather than fact based evidence (Mischel, Shoda & Ayduk, 2008). Those assessed using one of these methods could potentially provide nearly an infinite number of responses, many of which may not represent anything more than a creative mind’s thinking. Regardless of what a person sees when looking at a representation of one of these projective methods, the results should not be considered as symbolism for what is being repressed in their unconscious minds. The person’s creativity, logic, and many other aspects could easily be responsible for the answers and it may have nothing to do with unconscious thought. Regardless of what “unconscious inner life” a psychoanalysts would have hopes of unveiling using these projective methods, the results obtained fail to possess enough reliability and validity to be favored or respected as an accurate form of personality assessment and are thus dangerous to use. This is easily reinforced by the fact that legitimate research has found that these tests provide, “no evidence that the findings reflected the person’s unconscious mental states” (Mischel, Shoda & Ayduk, 2008). This further proves that the danger of a clinician’s assumptions of unconscious thought, drawn from a patient’s responses taking a projective method test, if inaccurate, will hinder a patient’s progress substantially.

2.) Transference in psychoanalytic theory was used when a client viewed their therapist as though they were someone from their past, such as a mother or father, allowing for a revisitation to conflict that affected the client (Mischel, Shoda & Ayduk, 2008). This allowed the therapist to bring a clients problems from childhood to the surface to understand the conflict more clearly and also help them cope with and move forward from it (Mischel, Shoda & Ayduk, 2008). Present day psychoanalysts continue to use transference in hopes of helping their clients in the same way as historical psychoanalysists used transference however, in other therapies I believe using this method is not truly necessary. CBT focuses on the present state of a client and how to explore and work through issues they are currently feeling rather than focus on past conflicts. Like Freud explained, I too believe transference happens in everyday relationships, most times unconsciously and that the occurrence is natural (Freud, 1977). Still though, while transference might allow patients to mentally revisit prior conflicts that caused instability for them, and though it may at times be beneficial to them, it is not entirely necessary for the “here and now” approach used in therapies like CBT (Mischel, Shoda & Ayduk, 2008).

We both drew to the same conclusion that while transference may be necessary and appropriate in psychoanalysis, in other forms of therapy such as CBT, for example, it is not. As an undergrad, my professor gave an example of transference that was different but helped me grasp the concept. My professor said that a patient who has infidelity issues might be seeing two different therapist for the same issue, and then talk about what the other therapist does within a session. One thing that really stuck out at me from yesterdays lecture in class was the conversation about countertransference. A therapist can become easily irritated with a client for no founded reason but it could be based on certain characteristics of the client. This could be unhelpful to the client and has potential to interfere with the effectiveness of therapy.

1. I agree, the inaccuracy of a projective method test can hinder a client’s progress in therapy. In my opinion, we need to consider the fact that the population being tested is a snapshot of data at a very specific place in time and society. This became very evident in our class last night when we were interpreting the TAT slide with the two men. Unless the data is updated regularly, no one can tell you whether that data is still “normative” one or two or three decades later. Society changes; people change; what they see in inkblots is also likely to change.

(1) The goal of psychotherapy is to reveal the unconscious motivation and struggles that drive outward behaviors (Mischel, Shoda, and Ayduk, 2008, p. 178). The characteristics of personality are the key components that tell us about a person’s unconscious motives, defenses and conflicts. Using the psychodynamic approach, it is believed that the driving motives across various situations and scenarios remain the same although the expressed, overt behavior may differ in order to actually fulfill these drives (Mischel et al., 2008, p.178). A psychodynamic method of assessment is the projective method in which an individual responds to unclear stimuli in any way and it is up to the clinician to interpret these responses to form a picture of personality. The main problem in using and relying on the psychodynamic assessment methods of projections is that the interpretation of these methods is very subjective and relies solely on clinician discretion (Mischel et al., 2008, p. 187). Interpretation of behavior and personality becomes vulnerable to biases and skewed to a clinician’s worldview rather than the client’s (Mischel et al., 2008, p.194). There is no evidence that the given responses are accurate or valid reflections of the “unconscious” or inner motives that drive behaviors; it is very difficult to determine “unconsciousness” (Mischel et al., 2008, p. 198). The given responses may also be due to the social situation and expected responses that a client might feel the need to give rather than because of unconscious motivations (Mischel et al., 2008, p.198).

(2) Transference in therapy occurs and can be used to restructure past life experiences in the present by transferring the thoughts and issues of the past figure onto the therapist; this allows for the client to relive the experience and instead of forming traumatic memories and responses, they are able to “work through” (Mischel et al., 2008, p.194) the issues in a healthier, adaptive manner through the therapist. Clients are able to repeatedly confront their problems and analyze their issues in different situations during therapy; this allows for them to build adaptive coping mechanisms and gain insight (Mischel et al., 2008, p.195). The goal of transference in therapy, through “self-insight” (Mischel et al., 2008, p.200), is very important to determine feelings, desires, and thoughts all which help shape personality and govern a person’s reaction to stressful situations (Mischel et al., 2008, p.203). Transference is seen as necessary in psychodynamic therapies; it is very useful and some aspects of this method are evident in other forms of therapy such as cognitive behavioral therapies. In cognitive behavioral therapies, it is through cognitive identification rather than transference that clients gain insight into their behaviors and motivations. This cognitive identification entails recognizing thinking patterns and behaviors and restructuring them to better react to situations in a healthier manner.

Your answer to number 1 was not entirely clear to me, is there a problem using projective methods or in the subjective nature of assessment? Any assessment, but most especially with projection methods, is liable to be subjective. It sounds like your critique is focusing on the assessments/interpretations are subjective as the reason for why there is no evidence behind projective methods. You are correct in saying that the client’s responses may be swayed based on social norms and expectations; however I do not think this is why it is difficult, dangerous, or ill-advised that projective methods be used. I think you are on the right track of getting to a full answer.
I found the connection you made between transference, in psychodynamic theory, and cognitive identification, in CBT, interesting. I have not heard of cognitive identification, so I cannot comment on whether I agree on the connection. Based on your brief description, it sounds very similar to transference with a more cognitive/behavioral focus rather than an unconscious focus.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?

In psychology today I believe that dangers would be the use of methods such as the Thematic Apperception Test (TAT). The TAT consists of a series of pictures and on blank card. The test taker or patient is then asked to tell the story of each card, what is happening at the moment, what they are feeling and the outcome of the story. This test leaves everything open for interpretation on both patient’s side and therapist side. The therapist must be the one to interpret the meaning of what the patient sees in the cards and score it. Many misinterpretations can happen with an experienced therapist let alone an inexperienced therapist. If you have an inexperienced therapist, a therapist not experienced enough with this test or with the client’s complete background it can be detrimental to the patient’s growth. It’s believed with this test that we are working with the unconscious, underlying fears/anxiety, impulses and defense to define ones behavior. It does not take into account a person’s environment they grew up in, their own personal experience or their own true feelings they are having at that moment. The need for achievement (n Ach) was explored through TAT using the” fantasy stories” already obtained. They found that the more stories that involved achievement themes, the higher the level of achievement motive occurred. However, are some people influenced by their own social experience such as the way they grew up? Some people have the advantage of supportive parents who have goals for the kids, provide standards and support along the way. These people will be perceived to have a higher motivation than others and if given the TAT will score in a higher manner. Just because someone may have a different drive in goals does not mean that it defines them as a person or their total personality.

(2) What are your thoughts about “transference” in therapy?

Transference is inevitable in any therapy situation. Transference in therapy occurs when a patient responds to the therapist as if they were the patient’s father, mother or other important childhood figure. The patient develops feelings or issues that they initially experienced as a child with these figures and are then transferring them back onto the therapist. I think that most people are looking for someone to feel comfortable with so that they can disclose their story. People want to be heard, want someone that makes them feel comfortable and non-judgmental. In positive transference between patient and therapist, the patient is able to use the therapist as a tool to project the feelings out in a healthy manner. The patient will be able to work through their problems in an appropriate manner by examining what the problems actually are. Once the problem is recognized they will be able to learn how to handle them in a more suitable way. This gives the patient power back and knowledge of their emotional behavior.

1) In my opinion the most dangerous consequence of continuing to use tests such as the Rorschach and the Thematic Apperception Test (TAT) is that we risk tarnishing Psychology’s reputation amongst laymen and other scientists. Psychology, is a science in its infancy, which to some extent excuses our use of tests with questionable validity as we have not been able to prove, beyond doubt, the effectiveness of a number of them. Having said that, the field as a whole is making a concerted effort to ensure that our measures are valid and reliable as is expected in scientific endeavors. However, quite a bit of research has been conducted about the validity and reliability of Psychoanalytic projective methods such as the Rorschach Inkblot and TAT, and the findings of these studies don’t seem to show that these are viable measurements by scientific standards. Studies show that these measures are extremely subjective and rely almost entirely on the psychologist for interpretation. The test does not make a clients’ response clear or provide it with meaning (Mischel, 2008). On top of there being little to no validity in these tests, there is also no possibility for establishing inter-rater reliability, which would make it difficult, if not impossible, for peer oversight or for clients to acquire a second, similar opinion from another professional. The continued use of subjective tests whose validity is controversial opens up both individual professionals and the fields as a whole to a great deal of liability and potential damage to our burgeoning standing in the scientific community.

2) Transference seems to simply be Freud’s understanding of the therapist-client relationship. It would be understandable that a client who is disclosing a number of unpleasant thoughts and feelings to their analyst would begin to experience feelings of emotional closeness to with that person. In this day and age we would consider it growth of the therapeutic relationship which is integral to growth and healing. Freud seems to attribute that same closeness to misplaced feelings of affection that should instead be directed towards a family member (2007). Although the feelings are somewhat misplaced, Psychoanalysis encourages transference by placing the analyst behind the client so that analyst can be whatever important childhood figure that the client needs them to be (Mischel, 2008).

“We risk tarnishing Psychology’s reputations amongst laymen and other scientists.” I didn’t really consider how these methods were viewed from those already working from within the field. You made an excellent point explaining that though the science hasdjkasdh Considering that those already working in the field are working so hard to provide valid evidence supported results, the use of tests like this which are far from reliable is not beneficial. My question is, if there is a lack of evidence to prove these tests are valid, why are so many psychologists still using them: In psychoanalysis, validity still has to have some importance as well?

Taylor you made a great point when discussing your take on transference. You explained that in modern day therapy an “emotional closeness” which a person may feel with whom they share their personal and often private experiences with, is not only normal but is also beneficial for growth. While this is true, I’m not sure that knowingly allowing and encouraging for the transference to continue is entirely beneficial for the client. Rather than viewing the therapist as someone to be trusted and as a helping figure, they may begin to be viewed with distrust and/or dislike simply because a client might unconsciously fall victim to transferring, thus bringing back direct feelings from their past and placing them on the main source that is trying to help them, not hinder them. In my opinion transference can be both good and bad and is a method that should be used with caution so that it remains beneficial and does not become a hindering factor in a client’s growth.

Regarding the first question about the projective tests, your guess is as good as mine! I don’t really understand why anyone would still use them either. Perhaps those who are follow psychoanalytic theory ascribe greater value to these tests than other clinicians.

On the second point, I don’t disagree with you at all. I think whether transference is beneficial or not would depend almost entirely on the quality of the relationship that the client had with the childhood figure they are connecting with. I imagine that if the client spoke to the clinician as someone who they loved, admired, or respected then it would possibly help the clinical relationship. If the client is imagining someone who hurt, neglected, or abused them then it would possibly be quite hazardous to a budding therapeutic relationship. I’m sure it just depends.

Regardless of whether it helped or hurt the trust and closeness that we now understand to be crucial to therapeutic relations, I’m not sure that Freud would have considered it important. As far as Freud seemed to be concerned, the childhood needed to come out, regardless of whether it is good or bad. I believe that Freud would argue that if there were negative feelings toward the person that the client projecting towards the analyst, what better way to find that out and to work through it than have the analyst “feel the wrath” of the client?

Heather Lawrence
1. Projective tests have a number of weaknesses and limitations. For example, the respondent’s answers can be heavily influenced by the examiner’s attitudes or the test setting. Scoring projective tests is also highly subjective, so interpretations of answers can vary dramatically from one examiner to the next. Additionally, projective tests that do not have standard grading scales tend to lack both validity and reliability.
In many cases, therapists use these tests to learn qualitative information about a client. Skeptics see it more as fiction created by a biased theoretical perspective through which therapists may damage their patients and their families (Mischel, W., & Shoda, Y., 2008). Clinicians worry that false memories may be unwittingly strengthened by therapists, particularly if they believe, as Freud did, that problems tend to stem from the abuse that the patient suffered as a child guided by that belief (Mischel, W., & Shoda, Y., 2008). Also according to our text, therapists easily encourage the patient to explore unconscious minds, searching for repressed memories that may not exist. “Instead of helping victims to reclaim lost pieces of their lives they may hurt innocent people and create rather than reduce stress” (Mischel, W., & Shoda, Y., 2008). However, these tests are still widely used by clinical psychologists and psychiatrists. Some experts suggest that the latest versions of many projective tests have both practical value and some validity.
2. Freud believed that transference arises spontaneously in all human relationships just as it does between a patient and the physician (Freud, S., 1977). He supported the belief that psycho-analysis does not create it, but merely reveals its consciousness and gains control of it in order to guide the psychical processes towards the desired goal(Freud, S.,1977). It is also the basis for the close relationship between the therapist and client that develops over the course of analysis. The client’s views transfers onto the therapist and may have feelings that they experienced initially with their parents (Mischel, W., & Shoda, Y., 2008). For example, a client may project their anger onto the therapist, viewing him/her as an authoritative figure which stems from a difficult childhood experience. In this situation, the therapist could redirect the victim’s anger toward non-destructive behaviors. In return, this would empower the client with a sense of control. I tend to naturally be at fault for being protective with an empathetic understanding of a client’s life. Although this is an important part of a therapeutic alliance, an overly close identification (countertransference) with a client’s struggle or suffering can lead to over protectiveness or inability to explore less than admirable aspects of a client. I believe as a mental health professional, it is our responsibility to promote self-efficacy and wellness in our clients. It is a mixture of our own values with the professional code of ethics, which guide their personal journey in life and the path they choose as part of the healing process.

You have great value in both of your statements regarding transference and countertransference. In a therapeutic setting you would want positive transference to happen in a relationship between therapist and client. Transference being that the client will respond to the therapist as if he or she were the patient’s father, mother or some other important childhood figure. The client will transfer their feelings and problems initially experienced in childhood by these figures onto the therapist. This is a great way for the therapist to be the tool in which the client can see the problems they may not have been aware of and then work through them. A client for example may be someone that struggles with anger or aggression and finds that they are struggling also with similar feelings of anger towards the therapist. This could be an unconscious feeling the stems from a childhood figure that they have feelings of anger pent up toward. The therapist is then able to work with the client to recognize the anger, examine it and find new ways to handle the emotions in an appropriate way. At the same time we need to be aware of countertransference which is a great point that you bring up. As therapists we all want to help and be there for our clients as much as we can. All of us have come from different backgrounds with our own stories that will sometimes relate to a patients story. We need to make sure that we do not put own our feelings onto our patient whether it be our personal views, aggravation with the patient progress or like you stated protectiveness over the client. Countertransference with a client is detrimental to their growth and process of healing, especially if you do not recognize and work through it.

1) I suppose a possible danger would be the potential of creating more false memories of childhood trauma within clients. Accurate and useful insights using such tools is neither easy to do nor can it be proven that the interpretations are accurate (Mischel, Shoda, & Ayduk, 2008, p. 184). The potential is higher for an inaccurate linkage to a false account of childhood trauma using such methods. Already you have a therapist who is looking for underlying sexual or aggressive motives and a client who could be vulnerable to the suggestions of the therapist. This combination of persons makes the chances of “uncovering” false memories all the more likely (Mischel et al., 2008, p. 201). These false memories can become vivid to the client and just as traumatic as if the trauma occurred and can also damage relationships between the client and the false abuser (Mischel et al., 2008, p. 201). Freud himself admits that people are concerned with causing more harm by using psychoanalysis (Freud, 1997, p. 59). Continued use of projective methods, in combination with associations and interpretations, could result in a discredit to psychology, specifically psychotherapy, as a practice because the use of inappropriate or ineffective methods becomes linked with the study of psychology.

2) The textbook has alluded to the fact that Freud and psychoanalysts place a heavy stock in transference as therapeutic content (Mischel et al., 2008, p. 194). In Freud’s lectures, however, little time is devoted to the topic of transference, so perhaps it was not nearly as important to him as the textbook seems to indicate. My personal thoughts on transference is that it is possible for it to occur however it is not always inevitable and I am not sure on its therapeutic value. I can easily imagine transference, as described by Freud (Freud, 1997, pp. 57-59), occurring if the therapist possesses either qualities and mannerisms similar to a parental figure or qualities and mannerisms the client believes to be ideal in a parental figure which were lacking in his or her childhood. My biggest issue with transference in the strictly psychodynamic sense, is that it seems as if there can be no true relationships between people because it spontaneously develops and the harder it is to detect the stronger or more successful the transference is (Freud, 1997, p. 58).

*Page numbers for Freud, 1997 are based on the assumption that the first page of the third lecture is 29, as a continuation from the previous reading, and that there are no additional pages (blank or otherwise) other than what was given in the pdf handout.

I agree with what you said about the lack of information about transference in Freud’s lectures. To be honest, I was disappointed. I was hoping to get a more in depth explanation from his own perspective so that I could have a better understanding of the concept. He spent a lot of time describing repression, including a nice little analogy. I think that perhaps some of why he didn’t go into detail may have had more to do with his time constraints than his lack of interest in this area. It seemed that throughout all five of his lectures he struggled with trying to explain psychoanalysis to a crowd who had no idea what it was, and wasn’t able to go into much detail about several topics. At one point, he even had to correct what he had said about stopping the use of hypnosis, explaining he was trying to graze over topics quickly. Based on what the text says, I wonder if there is other material out there where Freud talks more about his definition and application of transference in therapy.

The continued use of projective measures presents multiple dangers to the field of psychology due to the lack of their reliability and validity, and their overall subjectivity. Projective measures, such as the Rorschach test and the Thematic Apperception Test (TAT), are open-ended tests that allow individuals to answer freely and openly (Mischel, Shoda, Ayduk, 2008). While many psychoanalytic practitioners use projective techniques in hopes of discovering and projecting an individual’s unconscious thoughts there is no evidence that these methods have any construct validity. Additionally, due to the lack of regulation and operationalization of this method results are solely based on the clinician’s intuitions or feelings about the case opposed to scientific evidence (Mischel et al., 2008). The use of these subjective measures runs the risk of a clinician’s past experiences, history, and training background significantly impacting the interpretation of these tests. This not only prevents the client from coping with their current problems but could create added stressors and problems to the client as a result of the clinician manifesting something completely different than the client’s actual problem. This technique also has the potential to create false memories. False memories is when the therapist creates memories that may not be true through probing and suggestive questioning (Mischel et al., 2008).

Another technique used in psychodynamic therapy is transference (Freud, 1977). Transference occurs when the therapist ‘becomes’ an important childhood figure of the client. As a result the client expresses the feelings and problems experienced in childhood towards the therapist (Mischel et al., 2008). While this is believed to be extremely necessary in the process of psychoanalysis I think the process is more harmful than beneficial.

While I do agree with Freud that early life relationships can be demonstrated in later life relationships I do not agree with his technique of coping. The process of transference teaches the client that it is appropriate and effective to allow other people to become past important childhood figures and the appropriate way to cope with their emotions is by playing out that relationship as if the person was that past important childhood figure. While this may work in a session it does not translate to everyday life. Someone who does not understand or know about an individual’s past relationships will most likely respond negatively and therefore perpetuate the already negative emotions the individual is already experiencing. For example, if a client grew up angry with their mother and they later experience the resentment they have for their mother with a significant other transference teaches them to act fully on their emotions by expressing their anger and resentment for their mother towards that person. The significant other will most likely become frustrated with their anger and end the relationship. This will most likely anger the client even more and reinforce their anger, emotions and maladaptive behaviors. Failing to help the client learn skills on how to cope with future relationships that remind them of past hurtful relationships is a disservice to the client and has the potential to negatively impact the development of future relationships.

I really enjoyed reading about your thoughts on transference. While the textbook never explains whether it is a positive or negative experience, I initially assumed that it was a positive experience. The concept of transference seems simple at first: a patient applies the role of his or her parents (or other significant figure from childhood) to the therapist, thus allowing both the therapist and patient to work through the patient’s feelings. Although it is probably often assumed that parental figures in a child’s life are a positive influence for the child, this is not always true. Some children grow up in a chaotic environment — their homes– which may contribute to later issues for the child; perhaps these experiences are a reason why he or she is seeking help from a therapist in the first place. Therefore, it is likely that therapists experience a variety of responses from patients when transference takes place.

1) The continued use of projective methods poses numerous problems to the field of psychology. Perhaps the most egregious issue is the potential psychology damage–or at the very least, the stunted progress–that the practice would cause to patients. Because protective tests are measured “intuitively in accord with [the therapist’s] particular theoretical orientation,” the patient’s diagnosis is largely based upon what the therapist is expecting/hoping to find (Mischel, 2008). Therefore, the same patient may receive drastically different diagnoses depending on which theoretical orientation his or her therapist has adopted. Although there can be a lack of consensus regarding mental health diagnoses between practitioners even using scientifically-based methods, the reliability and validity of projective methods is comparatively quite poor (Mischel, 2008). An incorrect patient evaluation could lead to incorrect treatment methods, which would prevent proper psychological healing for the patient.
Projective methods are also detrimental to psychology as a whole due to the field’s current goal of becoming as scientifically based as possible. In order to be taken seriously in the medical field, psychology and psychiatry need to have the evidence to back up their claims. The most recent edition of the DSM, the DSM-5, has made it clear that the field is attempting to progress to the point where all of its claims can be substantiated by research (American Psychiatric Association, 2013). Continued use of projective measures would hinder this progress.

2) The text defines transference as “the view that the patient transfers onto the therapist many of the feelings experienced initially with the parents. In the course of therapy, these feelings are examined closely and ‘worked through’ until they become resolved” (Mischel, 2008). Although I want to refute this claim, here is some truth to it. Patients go to therapists for advise just as anyone may go to parents for advise. To attend a session is to admit that the therapist may have more insight than the patient, which creates a dynamic that could be compared to a child and parent relationship. However, the idea that this needs to be “worked through” during therapy assumes that the patient has underlying issues with his or her parents that need to be resolved which, despite what Freud believed, is not the case for many people. Additionally, there are many professional relationships that could be likened to a parent-child relationship in much the same way, such as the one between a person and his or her physician, and yet it would be absurd to claim that the relationship then needs to be “worked through” because of it.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?

Tests such as the Rorschach Inkblot Test and Thematic Apperseption Test (TAT) have not demonstrated strong validity or reliability (Mischel, Shoda & Ayduk, 2008). This is largely due to the open-ended nature of the tests. Clients are asked to give their thoughts on particular images, be them random ink stains on a card (Rorschach) or still life images that require a story (TAT). Answers are often non-specific or ambiguous. Practitioners then take these answers and interpret them however they choose. There is no real standardized answer or interpretation method (Mischel, Shoda & Ayduk, 2008). Another problem of these tests is that they claim to measure the “unconscious” thoughts of a client, as if the unconscious were a separate entity. Not only have these tests failed to show this is true (Mischel, Shoda & Ayduk, 2008), but the existence of the unconscious mind as psychodynamic theory teaches it has not been supported with empirical data. A flawed test from a flawed perspective is unlikely to give proper insight to a client’s problem.

(2) What are your thoughts about “transference” in therapy?

I personally have ambivalent feelings towards transference. On one hand, I can understand the utility. Proper transference can be used to allow a patient to quasi-recreate relationships or events that impacted their life but are no longer available to them (Freud, S., 1977), with the therapist playing the role of someone they are not. If relationship were truly toxic to a client (abusive father, deceased husband, attacker, etc) then the client needs a safe place to work through their issues. Transference can help the client work through their issues and gain insight into their own lives and problems (Freud, S., 1977). That being said, transference worries me to a degree. The idea that a healthy therapeutic alliance involves the client seeing the therapist as someone who causes them distress is hard for me to wrap my head around. Likewise, there is an unrealistic element about the whole situation. I can see how a client would be able to apply past experiences to current relationships, but transference seems to be a blurring of lines that should remain in place. Emotions are not just expressed by the client, but they are targeted at the therapist as if they were the original source (Mischel, Shoda & Ayduk, 2008). With a confusion of targets, how is rapport built?

Jason,
On transference in therapy, you stated “With a confusion of targets, how is rapport built?” Since transference is more or less like “re-enactment” of previous relationships, it can be an excellent opportunity for the therapist to provide insight and understandings with an analyst care and empathy guiding the client into an emotional experience that approximates what was needed in the former relationship thereby unraveling conflicts (including confusion of targets). A client could become independent as a result and learn how to address internal conflicts as related to similar relationships in he future.

I agree with your statement regarding how projective tests seemingly laser in on the unconscious and considered it a “separate entity”. In attempting to reveal the unconscious through projective testing, I think it is entirely possible to ignore more relevant and obvious personality features when engaged in this controversial testing. With the potential for such nebulous responses, I think that it would be very easy to misconstrue true emotions. Like Freud said, “Sometimes a watch is only a watch”. By trying to give meaning to these abstract inkblots, we have the strong potential to produce false memories.

Projective testing measures, such as the Rorschach Ink Blot Test and Thematic Apperception Test, were once top of the line tools in accessing the unconscious used by psychoanalysts but now face increased scrutiny. The continued usage of projective measures in modern practice poses not only an interesting ethical and moral dilemma, but a great concern in that the practice also lacks scientific support. The results and information obtained from these tests are characteristically determined by the analyst’s interpretation of the client’s description of the stimuli presented(Mischel, Shoda, and Ayduk, 2008, 178). With the analysts interpretation serving as the main source of information calls into questions both the reliability and validity of such measures of personality. The results obtained by these methods are for the most part both invalid and unreliable, in large part due to the results originating from within the analyst and not the client. These methods also prove problematic as it is possible for the analyst to insert their own motives in steering the course of therapy by using the power of suggestion. Numerous studies have spoken to concept of false memories and how conceptually easy it is for these ideas to become accepted as factual thought; it is very possible that the analyst’s interpretation of projective measures may induce these false memories ((Mischel et al.,2008, 201)
Transference is among the cornerstones of psychodynamic theory and plays an important role within that model while lacking wide spread support in other modern therapies. With the aim of psychodynamic therapy being to elicit unconscious behavior, analysts would embrace the unconscious projections of client’s feelings originating from previous conflict with influential figures towards themselves ((Mischel et al.,2008, 175). By embracing this unconscious construct of the client’s, the analyst would be able to work through unconscious issues but the conceptualization of modern therapy lacks the same emphasis on transference. Instead, modern therapies focus on an empathic and accepting environment where transference could be experienced but is instead analyzed and addressed. While it is evident that past experiences can influence transference in a therapeutic relationship, transference is no longer the vehicle necessary for therapeutic change and as such there is a diminished focus on the topic in modern therapy.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?

Often when I have watched videos discussing the use of projective tests such as, The Rorschach test, I am immediately skeptical of its efficacy. In chapter eight, it is openly stated that projective tests are open ended in the manner in which the test is structured (Mischel, Shoda, and Ayduk, 2008, 178). For this reason, it is not unreasonable to state that projective tests are open to a great dear of subjectivity. While the purpose of these tests are to free unconscious memories from the depths of repression, a comprehensive test by Kihlstrom in 2003 found that in no way do projective tests reflect a person’s unconscious (Mischel, Shoda, and Ayduk, 2008, 178). I believe that the danger of suggestion is relevant with the nature of projective tests. With so much subjectivity lying within this test, the therapist has a lot of pull over the patient. I think this is because the recipient of the therapy his often skeptical of the validity of their own answers. Now in the media we often see cases where patients who have claimed prior abuse, are often truly unsure if the abuse occurred. I think projective tests further open the possibility for the power of suggestion.

(2) What are your thoughts about “transference” in therapy?

I think transference is fascinating when it occurs in a therapeutic setting. Often we hear of the serial killer who “transferred” the anger from his abusive past onto his victims. While transference is unavoidable in therapy in my opinion, I do believe that transference in therapy can be very dangerous. As alluded to above, by encouraging a client to transfer their feelings onto a new object or person, you are never truly alleviating the problem the first presented itself. You can’t mask a psychological issue by transferring onto another entity.

I agree with your thoughts on projective methods. You allowed me to think of projective methods in a different light, especially when you mention that patients are likely skeptical of the validity of their own answers. When a therapist presents a TAT test to a patient, it makes sense that the patient would look up to the therapist as the one who knows the right answer, when in fact there is no right answer at all. Patients may rely far too much on the therapist’s “expertise,” not only valuing and taking to heart the interpretations offered, but also using the therapist’s power of suggestion — whether intentional or not– to create false memories.

While reading your posts the thought occurred to me that one of the problems with false memories is that they can be somewhat limitless. Under the psychoanalytic theory, in order to be free from the symptoms caused by a repressed memory, it has to be uncovered and relived. Following this idea, If a analyst “finds” a repressed memory and it doesn’t relieve the symptoms then it must be the wrong one which sends the analyst on a hunt for the “right” memory. It seems very much like a wild goose chase in the making.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods? (2) What are your thoughts about “transference” in therapy? Be sure to support both of your responses by the readings (i.e., not anecdotal opinions).

Despite a lack of scientific support for the effectiveness and validity of projective methods, many practitioners utilize these methods as part of treatment for clients. Not only does this impact the clients that they are treating, but also the field of psychology as a whole. Perhaps more than any other field, psychology has had to defend its credibility and the validity of its practices. Extensive research and measures have been conducted to increase the success and credibility of the field and the professionals within. Practices such as projective methods are highly subjective “and require clinicians to form their own judgments based on clinical experience and the “feel” of the case…it also depends on the evidence supporting the techniques upon which the psychologist relies” (178). If a psychologist relies on projective methods, which have “no evidence that the findings reflected the person’s unconscious mental states” (179), they are not only failing to properly treat their clients, they are also undermining the work that other psychologists do.

Another criticism of psychoanalysis is its use of transference. In transference, a client responds to the therapist as though they were a parental figure or an important person from childhood. The issue of transference is that it alters the trusting therapeutic relationship, which in itself can greatly impact a client. Secondly using transference does not necessarily solve the client’s problems that they have with that individual. The client is able to let off some steam, but never experiences actually confronting an individual, which can be quite therapeutic.

I agree that psychology does have to defend its own credibility and has been under scrutiny for years on end. These projective methods and tests leave everything open to much interpretation and do not provide concrete validity in its results. If you have a subjective test that guides the client to tell a story that will reveal their “unconscious” which in turn is interpreted by the therapist, you will not know the “true” meaning of the clients problem. The therapist can take the meaning of the interpretation however they want and the story told can have nothing to do with why the patient is there. It opens the door for the power of suggestion as well, so will these interpretations from the therapist then lead to new thoughts and feelings in the client? This definitely fails to properly treat the client like you state and also reaffirms your statement that it is undermining the work that psychologist do today.

You do have a point that these open ended interpretations of the projective methods could have devasteting outcomes like misdiagnosis and convincing a client into accepting that they have a disorder for which they actually don’t. For example, the test administrator or examiner attitude could influence the participants response. Also, the scoring of the test is subjective which could potentially be bias, one of the reasons why researchers say projective techniques could lead the over-perception of pathology.

You both mention the issue of priming or suggestion within the use of projective methods. I did not even think of this aspect. I mostly focused on the issue of the subjectivity of the therapist’s interpretation of the client’s results. However, in the therapist’s attempt at bringing the unconscious to the conscious, the therapist can prime or influence what the client may think of and therefore discuss. Not only can this possibly cause the client to “recover” false memories but can also lead to a false diagnosis. During free association, if a client does not know what to say or struggles to report what they are thinking, this can be perceived as resistance, or a defense mechanism. The therapist could then focus on this defense or resistance, and rather than solving a real issue, simply focus on a misunderstanding. Without empirical evidence of the effectiveness of projective methods, the subjective nature of projective methods can ultimately harm clients and fail to address the real issues.

(1) Although there is little to no scientific support for the use of projective methods, they are still used by many practitioners with psychodynamic backgrounds. What are some possible dangers to the practice of psychology for the continued use of such methods?
Psychodynamic theories and applications for centuries have been immensely criticized for lacking validity and reliability in practical applications. One of such applications or techniques is the projective methods. Psychoanalytically, clinicians who favor projective methods are under the assumption that with the presentation of ambiguous test situation, a person’s “unconscious inner life” to larger or partial extent is “projected” and revealed (Mischel, W., & Shoda, Y., 2008). This technique endorses free association in response to a stimulus to explain or uncover unconscious thoughts in hopes of explaining behavior or personality. Researchers like Kihlstrom(2003) concludes that even in few cases in which projective techniques had some validity, there was no evidence that the findings reflected the person’s unconscious mental states.
One of the dangers of the projective techniques is the over-perception of psychopathology. Even with the comprehensive guidelines for scoring developed, researchers identified flaws in scoring as related to duplication. For example, out the 700 protocols in the 1993 adult normative sample, 221 were duplicates (Exner, 2001, p. 172; J. E. Exner, personal communication, March 23, 2001). That is, the sample of 700 protocols was actually composed of 479 distinct protocols, with 221 protocols counted twice. With these flaws and shortcomings of the projective technique, most practitioners run the risk of misdiagnosing clients and convincing clients into accepting such diagnosis for which they actually don’t have. In the application of projective technique assessment to forensic practice, researchers believe that devastating outcomes could be incurred, especially in deciding cases such as granting parole to a prisoner or awarding custody to befitting parents.

To regulate or monitor the projective technique, most researchers think that test results or scorings of projective techniques should be in correlation with other well designed testing methods which have shown consistency in validity and reliability over time, in other words, when a client’s scores deviates significantly from the comprehensive system norms of projective technique, it shouldn’t be inferred that psychopathology is present. Also, given the dangers that could be incurred in primarily using the projective techniques for assessments, it should rather be considered as accompanying other well designed testing techniques rather than it being used as main technique for assessment.

(2) What are your thoughts about “transference” in therapy?
I think irrespective of therapeutic approaches, transference in therapy can be a good thing especially if it improves the therapeutic relationship but requires careful regulation by the therapist because it could also be potentially detrimental to the therapeutic relationship. For example, a client that has a good relationship with her father could transfer that relationship to her male therapist which could lead to breakthrough such as uncovering clues to thoughts, feelings, and behaviors outside of the client’s awareness.

Your response to number 1 was well expressed. The results, or rather the interpretation of the responses, are not only difficult to duplicate but also can lead to drastic outcomes. Placing a lot of stock in a method which yields unreliable results is never a good idea. I do like your suggestion of using projective tests in correlation with other methods. The hard part would be convincing clinicians who use these projective tests regularly as their primary assessment method to give up a little power to other methods.
In regards to number 2, I have to agree that transference is a tool which can either be beneficial or detrimental to therapy. I had not considered the effects of transference on the therapeutic relationship, although I am not surprised at the suggestion that it does.

I think that you evaluated transference as a both an asset and a threat to the therapeutic relationship. I mainly focused on the dangers of transference, or as a way to damage or alter the therapeutic relationship. However, as you pointed out if a client associates the relationship with the therapist to another supportive and stable relationship, it could allow a client to be more open and receptive to a therapist. If a therapist uses transference in a skillful way, I think that transference could be used as an asset in modern psychotherapy.

I think that you make an interesting point when you mention how transference can be helpful to the client/therapist relationship in certain situations. While it can be helpful, I think transference can also make therapy difficult. If a woman has had abusive relationships with men her entire life, she could very easily transfer her poor feelings towards males onto her therapist. This could make it very difficult for the therapist to have a conductive therapeutic relationship. I also agree with how you believe that strong regulation is needed to manage times of possible transference. It is very easy for clients to at times develop inappropriate feelings towards their therapist.